代偿期乙型肝炎肝硬化湿热证患者肠道菌群特征分析

An Analysis of Characteristics of Intestinal Flora in Patients with Compensated Hepatitis B Cirrhosis with Dampness-Heat Syndrome

目的:分析代偿期乙型肝炎肝硬化湿热证患者肠道菌群的结构特征。方法:选取2020年1—12月在广东省中医院珠海医院肝病科门诊和住院治疗的代偿期乙型肝炎肝硬化湿热证组33例、非湿热证组49例及对照组24例,对通过16srDNA技术提取的新鲜粪便样本总DNA进行测序,比较各组患者肠道菌群的分布差异。结果:湿热证组较非湿热证组的OTU种类以及独有OTU种类减少,但均多于对照组。湿热组与非湿热组Good-coverage指数较对照组升高,且湿热组与对照组比较,差异具有统计学意义(P<0.05)。PCoA结果显示,湿热证组菌群结构差异性大,与其他两组比较,差异具有统计学意义(P<0.05)。门分类水平上,对照组、非湿热证组、湿热证组放线菌门相对丰度值逐渐增高,且湿热证组与其他组比较,差异具有统计学意义(P<0.05);湿热证组绿菌门相对非湿热证组丰度值明显减少,湿热证组酸杆菌门相对其他两组丰度值均明显减少,差异均有统计学意义(P<0.05);属分类水平上,湿热证组巨单胞菌属相对其他两组丰度值均明显减少,差异具有统计学意义(P<0.05);对照组、非湿热证组、湿热证组双歧杆菌属相对丰度值逐渐增高,且湿热证组与其他两组比较,差异具有统计学意义(P<0.05);湿热证组乳酸杆菌属相对其他两组丰度值增多,且非湿热组与湿热组比较,差异具有统计学意义(P<0.05)。结论:代偿期乙型肝炎肝硬化患者存在肠道菌群失调,且湿热证肠道菌群物种丰富程度及多样性与非湿热证及健康对照人群存在明显差异。

Objective:To analyze the structural characteristics of intestinal flora in patients with compensated hepatitis B cirrhosis with dampness-heat syndrome.Methods:A total of 33 cases of compensated hepatitis B cirrhosis in the dampness-heat syndrome group,49 cases in the non dampness-heat syndrome group and 24 cases in the control group were selected from the outpatient and inpatient department of Hepatology,Zhuhai Hospital of Guangdong Provincial Hospital of Traditional Chinese Medicine from January to December 2020.The total DNA of fresh stool samples extracted by 16 srDNA technology was sequenced,and the distribution differences of intestinal flora in each group were compared.Results:The OTU types and unique OTU types in the dampness-heat syndrome group were fewer than those in the non dampness-heat syndrome group,but they were more than those in the control group.The good coverage index of the dampness-heat group and the non dampness-heat group was higher than that of the control group,and the difference between the dampness-heat group and the control group was statistically significant(P<0.05).The results of PCoA showed that there were significant differences in the structure of flora in the dampness-heat syndrome group compared with the other two groups(P<0.05).At the taxonomic level,the relative abundance of actinomycetes increased gradually among the control group,the non dampness-heat syndrome group and the dampness-heat syndrome group,and the difference between the dampness-heat syndrome group and the other groups was statistically significant(P<0.05).The abundance of chloromycetes in the dampness-heat syndrome group was significantly lower than that in the non dampness-heat syndrome group,and the abundance of acidobacteria in the dampness-heat syndrome group was significantly lower than that in the other two groups,and all the differences were statistically significant(P<0.05).At the level of genus classification,the abundance of megamonas in the dampness-heat syndrome group was significantly lower than that in the other two groups,and the difference was statistically significant(P<0.05).The relative abundance of bifidobacteria gradually increased among the control group,the non dampness-heat syndrome group and the dampness-heat syndrome group,and the difference between the dampness-heat syndrome group and the other two groups was statistically significant(P<0.05).The abundance of lactobacillus in the dampness-heat syndrome group increased compared with the other two groups,and there was significant difference between the non dampness-heat group and the dampness-heat group(P<0.05).Conclusion:There is imbalance of intestinal flora in patients with compensated hepatitis B cirrhosis,and the species richness and diversity of intestinal flora in dampness-heat syndrome are significantly different from those in non dampness-heat syndrome and healthy control population.